Abnormal liver stiffness assessed using transient elastography (Fibroscan®) in HIV-infected patients without HBV/HCV coinfection receiving combined antiretroviral treatment

PLoS One. 2013;8(1):e52720. doi: 10.1371/journal.pone.0052720. Epub 2013 Jan 3.

Abstract

Background and aims: Liver stiffness measurement (LSM) using transient elastography (Fibroscan®) can identify individuals with potential underlying liver disease. We evaluated the prevalence of abnormal LSM values as assessed using LSM and its predictors in HIV-infected asymptomatic patients receiving combined antiretroviral treatment (cART) without HBV/HCV coinfection.

Methods: We prospectively recruited 93 patients who had consistently been undergoing cART for more than 12 months at Severance Hospital in Seoul, Republic of Korea, from June to December 2010. LSM values >5.3 kPa were defined as abnormal.

Results: Thirty-nine (41.9%) had abnormal LSM values. On multivariate correlation analysis, the cumulative duration of boosted and unboosted protease inhibitors (PIs) were the independent factors which showed a negative and positive correlation to LSM values, respectively (β = -0.234, P = 0.023 and β = 0.430, P<0.001). In multivariate logistic regression analysis, the cumulative exposure duration of boosted-PIs and γ-glutamyltranspeptidase levels were selected as the independent predictors which showed a negative and positive correlation with abnormal LSM values, respectively (odds ratio [OR], 0.941; 95% confidence interval [CI], 0.889-0.997; P = 0.039 and OR, 1.032; 95% CI, 1.004-1.060; P = 0.023).

Conclusion: The high percentage of HIV-infected asymptomatic patients receiving cART without HBV/HCV coinfection had abnormal LSM values. The cumulative exposure duration of boosted-PIs and γ-GT level were independent predictors which showed a negative and positive correlation with abnormal LSM values, respectively.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • Coinfection
  • Cross-Sectional Studies
  • Elasticity Imaging Techniques / methods*
  • Female
  • HIV Infections / complications*
  • HIV Infections / pathology
  • Hepatitis B
  • Hepatitis C, Chronic
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Prospective Studies
  • Protease Inhibitors / pharmacology

Substances

  • Anti-Retroviral Agents
  • Protease Inhibitors

Grants and funding

This study was supported by a grant from the Good Health R & D Project, part of the Ministry of Health, Welfare and Family Affairs, Republic of Korea (A050021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.